Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

We are seeking a Carveout Data Analyst to help support operations for our growing implant and high cost drug audit business. Come join a talented team of data analysts, clinical auditors, and support staff who are helping to make healthcare more affordable! In this position, you will play a key role in supporting audit reviews through various parts of their lifecycle by assisting clinical staff, communicating with internal and external stakeholders, interacting with client systems, writing SQL code, researching contracts, and repricing claims.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Reprice claims and load audit results into client systems

• Prepare claims for offset and handle collection and appeal questions

• Validate claims against various factors to prepare them for audit scheduling

• Review contracts for audit opportunities and update contract details in our database

• Assist clinical and support staff with claim-related questions

• Use existing SQL code and write custom SQL code to answer questions, produce reports, and move claims through the audit lifecycle

• Produce reports with SQL and Excel for internal and external stakeholders

• Review large data sets to ensure their integrity, recognize trends, and present any opportunities or concerns to your colleagues

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School Diploma/ GED (or higher)

• 2+ years of experience with SQL (writing simple queries, running procedures, ability to troubleshoot query problems)

• Intermediate level of proficiency with Excel (e.g. formulas, sorts, VLOOKUP, etc.)

• Proven ability to follow long and complex workflows

• Proven attention to detail

Preferred Qualifications:

• 2 + years of experience in a healthcare or health insurance setting with knowledge of HIPAA requirements

• Contract and/or regulatory experience

• Experience using proprietary client systems

• Experience working on large data sets

• Tableau experience

• Proven effective communicator with good interpersonal and communication skills

Soft Skills:

• Accuracy and attention to detail

• Excited about working with a team of other analysts, growing as a coder, and going the extra mile to understand and solve problems

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington or Washington, D.C. Residents Only: The salary range for this role is $58,300 to $114,300 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.